Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | Q0083 | TX |
NPI | 1447450499 |
---|---|
Provider Name | Joshua Kilgore |
First Address | Dallas, TX 75391-1230 |
Second Address | Amarillo, TX 79106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 13/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
338187301 | (05) | TX |
338187302 | (05) | TX |
338187303 | (05) | TX |
338187305 | (05) | TX |
8EK638 | BLUE CROSS BLUE SHIELD (01) | TX |
8FX471 | BLUE CROSS BLUE SHIELD (01) | TX |